What happens when a rural community loses a hospital?

Jobs disappear. Hopes for economic development fade. Residents look for a new route to the nearest hospital.

Georgia has seen three rural hospitals close this year: Charlton Memorial Hospital in Folkston; Stewart-Webster Hospital in Richland; and Calhoun Memorial in Arlington.

A fourth, Flint River Hospital in Montezuma, closed its emergency room.

Officials with the hospitals said financial pressures forced them to go through with the closures. All were in areas that have struggled economically. But in a sad irony, the loss of a hospital usually weakens the economy of an area even further.

The consequences for patients and potential patients are grim when a hospital disappears.

The Florida Times-Union on Saturday published a harrowing account of what happened to Pam Renshaw, who rolled her four-wheeler over and landed in a bonfire in October in Charlton County, where the hospital had recently closed.

Renshaw’s boyfriend loaded her into his truck and drove her to the EMS station in Folkston, the newspaper reported. But no one was there, nor were there any ambulances, the article said.

Deputies told him that all of the county’s ambulances were in St. Marys, transporting others to the closest hospital.

So the couple waited. Eventually an ambulance and its crew of EMTs made it back to Folkston. EMTs took one look at Renshaw and called for an airlift to a hospital in Gainesville, Fla.

Renshaw is recovering now. Her sister, though, told the Times-Union: “We wanted to see the hospital stay. I still worry because my mom lives in the county, too. It’s too late to change anything in the county for my sister. But maybe they can do something to keep this from happening to someone else.”

Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in the state, said counties that lose hospitals “don’t have the access to catastrophic and lifesaving services.’’

And catastrophes such as tornadoes and plant explosions occur in rural Georgia as well as urban areas, Lewis told GHN on Monday.

When a county loses an ER, he said, emergency services or ambulances “turn into a health care taxicab.’’ And not all the transports are true emergencies, yet they can tie up services at any given time, he said.

Lewis said the answer comes down to money for rural communities.

He poses a tough question: Will a county or a state commit to funding health care as it does to funding police and garbage services?

Federal funding to care for low-income patients is declining with the health reform law, he noted. Thus rural hospitals and officials can face “excruciating decisions’’ on the future of health care in those communities, he said.

Expanding Medicaid “would help some,’’ Lewis said, “but is by no means a silver bullet.’’

Here’s a recent New York Times article focusing on the dispute over Medicaid expansion in Georgia, from the perspective of hospitals in the state, both urban and rural.

And here’s the link to the article on Charlton County and Pam Renshaw.